|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$564.00 |
$564.00 |
$564.00 |
$504.00
|
|
Injection, fulvestrant
|
$10,451.77 |
$10,451.77 |
$10,451.77 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$10,192.95 |
$10,192.95 |
$10,192.95 |
$6,830.50
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,539.00 |
$1,539.00 |
$1,539.00 |
$717.20
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,981.00 |
$3,981.00 |
$3,981.00 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,407.00 |
$1,407.00 |
$1,407.00 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,406.00 |
$3,406.00 |
$3,406.00 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,515.00 |
$2,515.00 |
$2,515.00 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$6,417.00 |
$6,417.00 |
$6,417.00 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,972.00 |
$1,972.00 |
$1,972.00 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,996.00 |
$3,996.00 |
$3,996.00 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$5,615.00 |
$5,615.00 |
$5,615.00 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,699.00 |
$1,699.00 |
$1,699.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$359.00 |
$359.00 |
$359.00 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$425.00 |
$425.00 |
$425.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$415.00 |
$415.00 |
$415.00 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$438.00 |
$438.00 |
$438.00 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$174.00 |
$174.00 |
$174.00 |
$141.60
|
|
Inject sacroiliac joint
|
$1,931.00 |
$1,931.00 |
$1,931.00 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$46,549.01 |
$46,549.01 |
$46,549.01 |
$32,176.93
|
|
Inj, fulvestrant (fresenius)
|
$2,140.16 |
$2,140.16 |
$2,140.16 |
$1,242.20
|
|
Inj, gadopiclenol, 1 ml
|
$297.73 |
$297.73 |
$297.73 |
$70.20
|
|
Inj gemcitabine hcl (accord)
|
$601.23 |
$601.23 |
$601.23 |
$374.24
|
|
Inj glycopyrrolate fres kabi
|
$35.01 |
$35.01 |
$35.01 |
$47.05
|
|
Inj intralesional <= 7 lsn(s)
|
$2,663.00 |
$2,663.00 |
$2,663.00 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$10,347.68 |
$10,347.68 |
$10,347.68 |
$7,173.90
|
|
Inj labetalol hcl hikma, 5mg
|
$49.16 |
$49.16 |
$49.16 |
$25.20
|
|
Inj, lidocaine w epinephrine
|
$161.85 |
$161.85 |
$161.85 |
$43.73
|
|
Inj mepivacaine hcl/10 ml
|
$16.13 |
$16.13 |
$16.13 |
$31.28
|
|
Inj multihance
|
$403.14 |
$403.14 |
$403.14 |
$119.25
|
|
Inj naloxone hydrochloride
|
$66.54 |
$66.54 |
$66.54 |
$95.36
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,539.00 |
$2,539.00 |
$2,539.00 |
$1,522.56
|
|
Inj octafluoropropane mic,ml
|
$155.71 |
$155.71 |
$155.71 |
$169.22
|
|
Inj proc elbow arthro
|
$564.00 |
$564.00 |
$564.00 |
$453.60
|
|
Inj retro urethrocysto
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$551.29
|
|
Inj secukinumab intrav 1mg
|
$6,380.61 |
$6,380.61 |
$6,380.61 |
$5,994.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$153,885.16 |
$153,885.16 |
$153,885.16 |
$178,150.09
|
|
Inj testosterone cypionate
|
$59.70 |
$59.70 |
$59.70 |
$82.58
|
|
Inj, tislelizumab-jsgr
|
$54,665.56 |
$54,665.56 |
$54,665.56 |
$103.20
|
|
Inj, vancomycin hcl (mylan)
|
$28.31 |
$28.31 |
$28.31 |
$89.83
|
|
Inj, vancomycin hcl (xellia)
|
$146.45 |
$146.45 |
$146.45 |
$192.59
|
|
Inj, vegzelma, 10 mg
|
$16,146.24 |
$16,146.24 |
$16,146.24 |
$1,444.45
|
|
Inj w/fluor eval cv device
|
$376.00 |
$376.00 |
$376.00 |
$588.90
|
|
Ins cerv dilator (sep proc)
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
$544.00
|
|
Insert cath pleura with image
|
$2,252.00 |
$2,252.00 |
$2,252.00 |
$2,239.02
|
|
Insert drug delivery implant
|
$1,565.00 |
$1,565.00 |
$1,565.00 |
$285.80
|
|
Insert intrauterine device iud
|
$3,052.00 |
$3,052.00 |
$3,052.00 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$840.00 |
$840.00 |
$840.00 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$516.00 |
$516.00 |
$516.00 |
$273.60
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,051.00 |
$4,051.00 |
$4,051.00 |
$2,618.40
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,707.00 |
$2,707.00 |
$2,707.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$7,117.00 |
$7,117.00 |
$7,117.00 |
$2,527.91
|
|
Insert pessary/other device
|
$1,321.00 |
$1,321.00 |
$1,321.00 |
$278.90
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$18,452.00 |
$18,452.00 |
$18,452.00 |
$4,705.13
|
|
In situ hybridization per specimen each additional single probe stain
|
$752.00 |
$752.00 |
$752.00 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$1,846.00 |
$1,846.00 |
$1,846.00 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$10,585.00 |
$10,585.00 |
$10,585.00 |
$4,341.66
|
|
Ins/rplc spi npg/rcvr pocket
|
$2,382.00 |
$2,382.00 |
$2,382.00 |
$21,097.15
|
|
Instillation anticarcinogenic agent bladder
|
$1,313.00 |
$1,313.00 |
$1,313.00 |
$721.50
|
|
Instill, bupivac and meloxic
|
$422.30 |
$422.30 |
$422.30 |
$786.78
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$31,593.00 |
$31,593.00 |
$31,593.00 |
$6,396.57
|
|
Ins tun cv cath wo subq prt/pm
|
$10,744.00 |
$10,744.00 |
$10,744.00 |
$4,748.00
|
|
Insulin total
|
$75.00 |
$75.00 |
$75.00 |
$67.60
|
|
Interrog device eval heart
|
$321.00 |
$321.00 |
$321.00 |
$150.00
|
|
Interrog evl pm/ldls pm ip
|
$130.00 |
$130.00 |
$130.00 |
$127.20
|
|
Intranasal biopsy 30100
|
$11,990.00 |
$11,990.00 |
$11,990.00 |
$1,850.94
|
|
Intrauterine transfusion ftl
|
$4,510.00 |
$4,510.00 |
$4,510.00 |
$1,004.25
|
|
Intrinsic factor antibody
|
$231.00 |
$231.00 |
$231.00 |
$59.95
|
|
Intro long gi tube
|
$496.00 |
$496.00 |
$496.00 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$772.00 |
$772.00 |
$772.00 |
$477.85
|
|
Intubation endotracheal emergency procedure
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$483.60 |
$483.60 |
$483.60 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$753.66 |
$753.66 |
$753.66 |
$182.21
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$62,257.63 |
$62,257.63 |
$62,257.63 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$8.31 |
$8.31 |
$8.31 |
$4.77
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$311.60 |
$311.60 |
$311.60 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$5,626.93 |
$5,626.93 |
$5,626.93 |
$5,837.00
|
|
Iron
|
$110.00 |
$110.00 |
$110.00 |
$70.72
|
|
Iron binding capacity
|
$75.00 |
$75.00 |
$75.00 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$60.47 |
$60.47 |
$60.47 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$130.84 |
$130.84 |
$130.84 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$166.00 |
$166.00 |
$166.00 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$273.00 |
$273.00 |
$273.00 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$18,863.10 |
$18,863.10 |
$18,863.10 |
$8,335.70
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$244.00 |
$244.00 |
$244.00 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$237.00 |
$237.00 |
$237.00 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$326.00 |
$326.00 |
$326.00 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$712.00 |
$712.00 |
$712.00 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$1,363.00 |
$1,363.00 |
$1,363.00 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$378.30
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$97.00 |
$97.00 |
$97.00 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$44.55 |
$44.55 |
$44.55 |
$29.52
|
|
Kidney imag w/bld flow multi
|
$2,634.00 |
$2,634.00 |
$2,634.00 |
$1,566.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$598.67 |
$598.67 |
$598.67 |
$103.20
|
|
Knee MRI (with and without contrast)
|
$7,320.00 |
$7,320.00 |
$7,320.00 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$5,821.00 |
$5,821.00 |
$5,821.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$4,104.00 |
$4,104.00 |
$4,104.00 |
$2,181.10
|
|
Knee X-ray
|
$623.00 |
$623.00 |
$623.00 |
$443.90
|
